barrett's%20esophagus
BARRETT'S ESOPHAGUS
Barrett's esophagus is defined as the endoscopic finding in the distal esophagus of proximal-appearing columnar-lined esophagus of at least 1-cm length that is confirmed by histology.
It is considered a premalignant metaplastic condition that usually involves the distal esophagus.
It is postulated that exposure of the esophageal epithelium to acid damages the lining resulting in chronic esophagitis and its healing involves metaplastic process.

Surgical Intervention

  • Appropriate surgical candidates may consider fundoplication to control reflux symptoms
  • Surgical intervention to prevent adenocarcinoma remains unproven

Esophagectomy 

  • Some clinicians recommend esophagectomy for healthy patients with high-grade dysplasia or patients with invasion of the submucosa, lymph node metastasis or failed endoscopic therapy

Considerations for Esophagectomy

  • Esophagectomy is associated with higher morbidity and mortality at low-volume institutions
  • The natural history of high-grade dysplasia is variable and therefore, the decision to perform esophagectomy should be carefully considered
  • Esophagectomy at a high-volume institution may be considered in patients who are fit for surgery with recurrent diffuse high-grade dysplasia that is confirmed by an expert gastrointestinal pathologist
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
13 Mar 2017
The serum pepsinogen test—which is relatively simple, inexpensive, sensitive and specific—is a potentially viable method for the screening and detection of Kazakh early gastric cancer, a new study claims.
24 Apr 2017

Helicobacter pylori (H. pylori) infection is associated with conditions such as gastritis, peptic ulcer, gastric cancer, and certain types of lymphoma. A common presenting complaint among all these H. pylori-related illnesses is dyspepsia. Dr Desmond Wai from the Desmond Wai Liver and Gastrointestinal Diseases Centre, Mount Elizabeth Novena Specialist Centre, Singapore, speaks on the important role general practitioners (GPs) play in recognizing, diagnosing, and treating H. pylori.

Pearl Toh, 24 Nov 2016
New treatments such as pirfenidone and nintedanib slow lung function decline and progression of idiopathic pulmonary fibrosis (IPF), although response to treatment can vary dramatically among patients, according to a presentation at the 21st Congress of the Asian Pacific Society of Respirology (APSR 2016) held in Bangkok, Thailand.